No abstract

Methods Retrospective review of case notes and Badger discharge summary of an infant admitted to a level 3 district general hospital NICU in 2017. Results Baby F is a 36 weeker born in good condition to a multiparous mother with an unremarkable antenatal history. Admitted from postnatal ward at 2 hours old due to respiratory distress and hypoxia.Deteriorated despite non-invasive ventilation thus intubated for surfactant administration and conventional ventilation. Chest x-ray (CXR) revealed large pneumomediastinum. Required 100% fraction of inspired oxygen (FiO2) thus changed to high frequency oscillator ventilation and started inhaled nitric oxide (iNO) for presumed persistent pulmonary hypertension of the newborn (PPHN) Echocardiogram by attending neonatologist showed a small right ventricle and an echogenic mass on the TV causing obstruction and tricuspid regurgitation (TR). Transferred to the regional cardiothoracic centre on prostaglandin infusion for suspected tricuspid atresia.Discussed at cardiothoracic multidisciplinary team meeting. Differential diagnoses:

BackgroundPaediatricians are commonly asked if they have their own children. Some evidence suggests that paediatricians who have children are perceived by parents to be more credible. Trust and credibility have been identified as important factors in the doctor-patient relationship. There is little research looking into whether paediatricians believe that their own parental status makes a difference to their clinical practice.AimTo establish if paediatricians perceive a difference in practice between those who have and those who do not have children, and identify potential learning needs.MethodWe held four focus groups with paediatricians based in two hospitals. Each group was facilitated by a member of our team and recorded with consent of the participants. Key themes were identified and explored.ResultsWe obtained the views of 29 doctors at every level of paediatric training including consultants; 14 had children.Doctors with children expressed strong opinions that personal experience of parenting was advantageous. They felt they were more empathetic in certain situations, had greater understanding of parental anxiety and spent more time communicating with families. Confidence was increased in assessing development and giving breastfeeding advice. Parental status of the paediatrician was not thought to affect their clinical decision-making process.Doctors without children suggested that experience and training were more important than parental status in the development of their communication skills. They suggested that having young relatives assisted in learning about developmental milestones. Most participants without children did not feel able to give breastfeeding advice.Independent of parental status, participants felt that additional training in communication, development, breast feeding and child behaviour would be beneficial.ConclusionParticipants held similar views to those previously identified in parents that having children may improve understanding of parental anxiety and communication with families. This may increase credibility. All participants could identify areas where additional training could improve practice. Whether having children affects the clinical practice of a paediatrician is an emotive topic and we have illustrated a range of viewpoints on this issue.